On treating very early traumatic memories

Recently I attended a symposium on memory and trauma in children. During the lunch break the room was crowded. Two friendly psychotherapists offered a place at their table. One of them shared her experience with a young child who had been so terrified of death that it had interfered with going to school. Nothing had helped, the therapist said, until she learned from the parents that the child’s birth had been extremely difficult. So, assuming that this near-fatality lay at the root of the problem, she targeted the child’s birth memory. There was no conscious memory of the birth, but that did not matter much to the therapist. She reactivated the child’s memory by having the parents describe what had happened. And … it worked! The child was no longer terrified of death. The therapist was excited about solving the child’s problem. For me, such a case raises intriguing questions.

Infant memories

How far back can we remember? Adults have few, if any, memories of the first years of their lives. It has long been assumed that infants are not able to form memories at all. Yet, recent clever studies, looking at nonverbal indices of memory showed that infants as young as 2 months recognize a toy for as long as 2 days after learning (Rovee-Collier & Cuengas, 2009). With increasing age, the retention interval rises steeply. Does this mean that these short-lived memories in infants are similar to adult memories? It depends on how memory is defined.

Traveling back in time

In an influential theory, Endel Tulving coined the term “episodic memory” to refer to a memory system supporting the unique experience of remembering (see Tulving, 2005, for his latest insights). For example, thinking back of my last hike along a beach, I have a strong sense of reliving the event. I can almost see the sea’s silvery glimmer in the late afternoon light. I can almost smell the salty waters. This is accompanied by a sense of “pastness” and the distinct feeling that it is me on that beach. It is doubtful that infants – who have yet to develop a concept of time and a sense of self (Howe, 2014) – are able to re-experience being at a beach in a similar fashion.

Reactivating preverbal memories

Nevertheless, we are shaped by our early experiences – these lay the foundation for the knowledge and skills we rely on when navigating through daily life. This knowledge and these skills are likely to be an abstract residue of many similar situations from the past. However, the literature on infant memory (Rovee-Collier & Cuengas, 2009; Lukowski & Bauer, 2014) suggests that behavioural traces of single, unique, events (e.g., an increase in foot kicks upon presentation of the specific mobile toy that figured in an earlier experimental session) may be retained longer if reactivated by reminders, such as the original environment, the original objects, and the original actions. For prolonging the retention of this “preverbal memory”, the reminders should have been present at the time of the original experience. The younger the child, the more specific these reminders should be and the more frequently they need to be presented.

What about trauma memories?

We don’t really know if and how traumatic memories in infants differ from everyday memories. Obvious ethical constraints render it impossible to study memory for trauma in similar ways as memory for situations involving playing with toys. Personally, I think it is unlikely that birth trauma memories drive behavior in such specific ways as in the case of the child with death anxiety. It is still unknown if and for how long perinatal experiences can be retained. Moreover, to avoid forgetting during infancy, such a hypothetical birth trauma memory should have been reactivated multiple times by specific environmental features.

Nevertheless, the child’s therapist seemed convinced about the toxicity of the birth “memory”, partly because her therapy was effective. Yet, the fact that treating this “memory” seemed to help does not mean that a memory caused the problem. There may be many alternative causes for the problem and, similarly, there may be alternative explanations for the child’s recovery.

Why bother?

One might argue that as long as clients get better, therapy does what it should do and the underlying mechanisms are of less importance. Yet, in spite of satisfied (ex-) clients, therapy relying on bad theory may have adverse side-effects. Memory is malleable. Children and adults may confidently hold memories about things that did not happen or that are highly unlikely to have happened, such as abduction by aliens (Otgaar et al., 2009). If we rely on the idea that psychopathological symptoms directly result from preverbal experience without explicit recollection, and that reworking those experiences is required for the problems to subside, then we may start searching for traumas that never happened. Instead, we should concentrate on searching for alternative explanations.

References

Howe, M. L. (2014). The co-emergence of the self and autobiographical memory: An adaptive view of early memory. In P. J. Bauer, & R. Fivush (Eds.), The Wiley Handbook on the Development of Children’s Memory, (1rst Edition) (pp. 545-254) Wiley-Blackwell.

Ineke Wessel received her PhD degree from Maastricht University. Her work applies to clinical psychology (e.g. Memory processes in Posttraumatic Stress Disorder), as well as forensic psychology (eyewitness memory). Basically, Ineke is interested in everything that has to do with the question of how people remember emotional events. Current projects involve the development of episodic memory in preschoolers, the influence of collaboration on emotional memory, the link between cognitive control and intrusive memory, and the characteristics of autobiographical memories in psychopathology. For more information, you can visit her website.